Otitis media is a general term used to describe inflammation of the middle ear which may be caused by an acute infection.
The symptoms are usually nonspecific and include otalgia (pulling of ear in an infant), irritability, otorrhea with or without fever.
Symptoms of upper respiratory tract infection may also be present

Children previously treated with Amoxicillin within the last 30 days or diagnosed with concurrent purulent conjunctivitis or with a history of recurrent unresponsive to Amoxicillin, should be given antibiotics with beta-lactamase coverage

Shift to other antibiotics if child’s symptoms worsen or disease is unresponsive within 48-72 hours of treatment

Pharmacotherapy

Symptomatic Therapy

Analgesics

Eg Paracetamol (Acetaminophen), Ibuprofen

Considered the mainstay of pain relief for acute otitis media (AOM)

Effective analgesia for mild-moderate pain

Topical agents

Eg Benzocaine, Lidocaine, Procaine

May provide temporary relief in patients >5 years old

Antibiotic TherapyAmoxicillin/High-dose Amoxicillin

Amoxicillin at sufficient doses is still considered the 1st-line agent for AOM

Recommended for pediatric patients without history of antibiotic intake within the last 30 days prior to administration of Amoxicillin

Child should be concurrent purulent conjunctivitis-free & without history of allergy to Penicillin

It is effective against most of the bacteria which cause AOM including susceptible & intermediate-resistant pneumococci

In areas where penicillin-resistant/nonsusceptible pneumococci are common, high-dose Amoxicillin should be given

Amoxicillin/Clavulanic acid (High dose)

High doses of Amoxicillin combined with Clavulanic acid are recommended for patients who fail standard Amoxicillin therapy or in those who present with severe or recurrent illness

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